MEDICARE: BRIAN REASONER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP30007918	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417131426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN REASONER NP

Provider Business Mailing Address
First Line	:	2550 N. THUNDERBIRD CIRCLE
Second Line	:	NEXTCARE URGENT CARE
City	:	MESA
State	:	AZ
Zip	:	85215-1219
Country	:	US
Telephone Number	:	480-353-2235
Fax Number	:	480-776-0025

Provider Business Practice Location Address
First Line	:	5369 S. CALLE SANTA CRUZ
Second Line	:	SUITE 145 NEXTCARE URGENT CARE
City	:	TUCSON
State	:	AZ
Zip	:	85706
Country	:	US
Telephone Number	:	520-573-7500
Fax Number	:	480-776-0025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2007
Last Update Date	:	12/10/2013

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